A familiar feeling of sweaty palms, an upturned stomach, racing thoughts, and increased heartbeat is what many people have experienced in their life time. This phenomenon usually occurs when we are put into situations that trigger our flight or fight responses. However, for those with Social Anxiety Disorder (SAD), also known as social phobia, these moments are experienced frequently on a daily basis with extreme intensities.
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SAD can be defined as an overwhelming anxiety with excessive and difficult to control worries or fears about social interactions or scrutiny (Falk & Leweke, 2017). The origins of the disorder may be a result from high exposures of either stressful and negative events that one has experienced from childhood or adulthood (National Institute of Mental Health, 2016). Previous history of anxiety or other mental disorders may also be a source of origin for SAD. It is a common anxiety disorder that can be found among 33% of college students (Brook & Willoughby 2015) and has a large impact on their academic and social performances. In this paper, it will address how SAD impacts college students and their dimensions of wellness.
Signs and symptoms of SAD are similar to the vivid imagery described in the introduction. According to the DSM-IV, typical symptoms would include difficulty in controlling worries, general avoidance, large restrictions with speaking in public, body dysmorphia, and intense nervousness (American Psychiatric Association, 2013). More physical symptoms would include intensive blushing, trembling, stiff muscles, increased heartbeats, dry throat or mouth, and dizziness (American Psychiatric Association, 2013). This disorder is often mistaken for the typical shyness, when in reality it is something more extreme. With the flight-or-fight responses, people with SAD also tend to have thoughts that revolve around the judgments by others. Due to these thoughts, they tend to feel very uncomfortable and in some cases, may even break down and have a panic attack. It impacts 50% of children, as early as 11 years of age, and 80% of those at age 20 (Stien & Stien, 2008). SAD is becoming an increasing and alarming mental disorder that must be addressed.
Therefore, getting the proper treatment for SAD is essential. For only 35% of those who have chronic SAD get the proper treatment for it (Falk & Leweke, 2017). With SAD alone, they are already at high risk for cardiovascular disease and disorders related to substance-use or depression (Falk & Leweke, 2017). Some of the most effective methods of treatment are psychotherapy, cognitive behavioral therapy, medications, antidepressants, beta-blockers, stress management techniques, and support groups (National Institute of Mental Health, 2016). By getting these treatments, they significantly prevent the previously mentioned risks and cope more efficiently with SAD. The intensity of their symptoms may be decreased as well since they have a source of treatment to help them pull through those social moments.
However, college students often do not use any of the given treatment methods. Based from the National Alliance on Mental Illnesses (2016), approximately 75% of the mental health conditions arise at age 24, leaving college students clueless in how to cope with them (Chiu & Graham, 2017). It is found that the most popular coping method among SAD diagnosed college students is through heavy drinking. In fact, it is reported about 48% of students who have SAD are also diagnosed with some type of alcohol disorder (Ham, 2009). A negative effect from this coping method is that it is a gateway to associate alcohol consumption or alcohol use disorder (AUD) (Sarah & Carrie, 2002). Alcohol is known to deteriorate one’s important organs such as the liver, brain, heart, and pancreas. As stated earlier, it may also lead to other disorders such as, depression, eating disorder, or other anxiety-related disorders (Nordstrom, Goguen & Hiester, 2014). As a result, it shows how big of an impact that SAD has upon college students and their dimensions of wellness when it comes to self-coping.
For every action there is a particular reason, which applies to why college students with SAD confide to drinking alcohol. Majority of students use alcohol as a coping method because it helps relief their fears and uncomfortableness while they are out in public. They are lead to believe that by using alcohol and getting intoxicated, they can reduce the amount of anxiety they have for the time being (Book & Randall, 2002). Another reason may be due to the fact that around this age, many of their peers are also using alcohol and other forms of drugs. This causes them to be susceptible to peer-pressure and get the high possibility of addiction to any given drug. All of this ties into the smaller and detailed factors that many forget to consider when analyzing those with SAD, their environments, current situation and their group associations (Lindsay et al., 2011). Where alcohol outcome expectancies are considered and three other main reasons for drinking: negative coping, personal-intimates, or convivial. The anxiety causes students to have intensive symptoms when out and about in social settings, such as parties. Although alcohol is bad for their health and not the best coping method, it is not primarily their fault for falling into the addictive trap of the beverage.
With social anxiety, there are both positive and negative effects that intertwine with it.
The negative effects are associated with their ability to do well in school and establish relationships with others. Most of them will do whatever it takes to avoid situations where social interactions are required due to their fear from SAD (Lipton et al., 2016). They often avoiding social etiquettes such as direct eye contact and projection of the voice. Their thoughts when engaging in social events are increase in negativity as well, usually regarding about themselves (Pictet, 2014). Due to their tendencies to avoid social interactions, some college students may decide to skip classes in order to keep their SAD symptoms on a low level. Their grades may drop as a result, and their ability to achieve a aspired career is diminished. They are also unable to handle stress well and may result in using drugs or alcohol to cope with it (Lipton et al. 2016). It also impacts their self-imagery because they are constantly in fear of others judging them, leading them to be very self-conscious about their appearance and actions.
Moreover, negative effects involved with SAD include deterioration in the body’s overall optimal health. It can cause frequent headaches, high irritability, fatigue, increase in blood pressure, and a sense of impending doom. Without a stable physical and mental health, the other dimensions of wellness deteriorate in response. This is why many students who have SAD have higher risks in obtaining depression because their state of mind is often thrown to such mentality. Similar to simply avoiding social interactions, they may avoid work areas or school entirely as well as social groups like friends or family. As mentioned before, due to the low dimension wellness levels, they are most likely to develop another disorder on top of the social anxiety they already have. Ultimately, it would lead them to a downwards spiraling path of unhealthy amount of stress and health problems, both physically and mentally.
On the contrary, a positive effect of social anxiety can be derived from a positive self image. With a positive self-image, they are able to form more positive biases when interacting with others or may even use their anxiety as a method of motivation (Pictet, 2014). They are also able to hold and express stronger emotions, exhibiting stellar empathy or sympathy to others. This results in a good trait that many seeks in potential friendships, enabling the student with SAD to overcome their weakness in establishing friendships. Another positive is that it allows the person to be more aware or alert since anxiety is the main embodiment of social anxiety. It triggers the flight-or-fight responses that enhances one’s survival abilities in cases of endangerment. (Lee, Wadsworth & Hotopf, 2006). They also share strong attributes in leadership traits because of their tendency to consider all the possible outcomes. This derives from their ability of being constantly aware of what could make a bad turn. There are just as many pros as there is cons from having social anxiety, which can either benefit or limit a college student’s ability to succeed.
On a national level, there is an organization dubbed The National Social Anxiety Center (NSAC) that provides services to treat those with SAD. In this organization, they provide psychotherapy, a therapy that involves talking about ones’ mental disorder or emotions, across the United States in a multitude of regions. In psychotherapy, a strong relationship between the client and psychologist is made and work together through talking in order to resolve the issue that the client has (American Psychological Association, 2016). With NSAC, they specifically use cognitive-behavioral therapy, a type of psychotherapy. Cognitive-behavioral therapy helps an individual obtain new skills or strategies that help resolve inner-conflicts and achieve any set goal. The organization provides this therapy either individually or in groups, that both effectively help make a difference with SAD. It is a efficient way for college students to connect with those who have similar experiences with social anxiety and obtain more knowledge on how to cope with it.
Meanwhile on more local/state level, a community organization called NOSIRI Empowerment Center that helps those with social anxiety and their abilities in public speaking. It is located in Crofton and provides help to those who live in Washington DC, Maryland, Virginia and anyone who participates in their online classes. This organization helps supports one’s confidence, self-esteem, and leadership skills as well through the formatting of counseling. It seems to have more variety than the national level organization and describes more in depth about their objective for each category that the person with SAD wants to improve on.
Social anxiety disorder has hindered many college students in both academics and their over all wellbeing. It impacts them by limiting their ability to create strong relationships and their interaction or participation in social situations. The fear that is created from the anxiety overwhelms their cognitive abilities, leaving them to suffer the mental and physical trauma effects of long-term flight-or-fight responses. They are driven to cope with SAD through heavy drinking that leads them to become diagnosed with alcohol disorders. Not only can they become double diagnosed with alcohol disorders, but health or other mental disorders too, such as depression and body dysmorphic disorder. Despite the large negatives, their social anxiety helps provide them with empathetic abilities, leadership skills, and a constant mind of awareness. Organizations such as NSAC and NOSIRI provide strong support systems for those who suffer from SAD. It is very efficient for college students because not only do they get a variety of therapies, they are able get quality take away methods in coping and meet others who also have SAD. A suggestion to help aid those who have social anxiety is to give them supportive and encouraging words, to coax them out from SAD symptoms while out in social events. More support groups should be available on the college students’ campuses so they have somewhere to go if they begin to experience their anxiety symptoms, or if they need someone to talk to about it. Meanwhile, a suggestion to help prevent it is to expose both children and adolescents with positive and optimistic views that will help raise their self confidences. Exposure to social interactions and public speaking will help prevent the possibility of SAD developing when prevention occurs during their youth. In whole, SAD can be prevented with early prevention and has the potential to be coped with safely if given the right treatment methods. Even though SAD is shown to negatively impact a college student’s well being and academics, they have their ways to over come the symptoms and triumph to the top.
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